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Internal tremors: What specialist helped you?

Brain & Nervous System | Last Active: Jan 15 8:07am | Replies (28)

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@concernsinphoenix

Hello, about 4 months ago I started noticing numbness and tingling in my right hand, with some arm and shoulder pain. I saw my GP who thought it could be arthritis and carpel tunnel. I told her I had also been feeling anxious after returning to work five months earlier after a year long break. She recommended physical therapy and prescribed Lexapro. Shortly after this I started experiencing numbness and tingling in my other hand and sometimes in my feet when sitting. I saw a new GP (because my old one left) three weeks later. I was still having lots of numbness and tingling and terrible insomnia from Lexapro. I had also started to notice a very slight tremor in my face only when I held my mouth open. The new GP thought this was probably anxiety and Lexapro was not a good choice for me. She switched me over to Zoloft and Clonazepam. After about 10 days on this combination I began to notice an internal vibration, more on my left side and some more pronounced aching and mild weakness in my shoulders and arms. She told me Zoloft can cause tremors and I should stop taking it, but to continue taking the clonazepam. A week later I was still noticing an internal vibration, aching and weakness, she told me to stop clonazepam as well. In the interim, she ordered a brain MRI, which I had and was normal. I have now been off all of these medications for 5+ weeks and if anything the internal vibration, while still intermittent, feels more noticeable, especially in my lips. Over the last week I have also been noticing more neck pain and pain in my right collarbone area. I have an appointment with a neurologist in about 5 weeks. I also saw a nurse practitioner in psychiatry who has recommended that I take gabapentin and lorazepam. Not sure I want to do this as I had no tremor before taking anti-depressants. Are there providers I should be talking to in addition to neurology at this point? Thanks for any insights.

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Replies to "Hello, about 4 months ago I started noticing numbness and tingling in my right hand, with..."

@concernsinphoenix Hello and I wanted to give you a warm welcome to Connect. I think a neurologist is the right specialist for you to see right now. I have had the pain you describe near the collar bone, neck, shoulder, and arm pain. My symptoms are from thoracic outlet syndrome, and a cervical spine issue. I had a whiplash many years ago, and eventually a ruptured disc that started compressing my spinal cord. I was already in physical therapy for the TOS at the time I started having spine symptoms. I hope your neurologist will send you for a cervical MRI and test you for TOS.

I had spine surgery which helped a lot, but the TOS remained. That is a long term physical therapy treatment and my PT also does myofascial release which does help a lot. A lot of doctors do not understand TOS and miss it. If you are near the Mayo Clinic in Phoenix, that would be a good place for a TOS diagnosis because this is something that Mayo can diagnose and treat. There is a compression point under the collar bone and near the arm pit that a can be painful spots. If you do also have a cervical spine issues, Mayo is a great place to be seen for that as well if it is in your insurance network. Nerve compressions can cause the tremors. TOS also restricts blood flow to the arms and head.

Here are some links to information.
https://www.mayoclinic.org/diseases-conditions/thoracic-outlet-syndrome/symptoms-causes/syc-20353988
https://mskneurology.com/how-truly-treat-thoracic-outlet-syndrome/
Here is our Myofascial Release discussion:
https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/
Have you heard about Myofascial Release therapy before?

Hello @concernsinphoenix. I would like to add my welcome along with @jenniferhunter, who has joined you with some questions.

Since we already have an existing discussion going on Internal Tremors, you will see that I have moved your post here: https://connect.mayoclinic.org/discussion/internal-tremors/

I will let you respond to Jennifer. Glad to have you on Connect!

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